Question:
BCBS Says they don't cover surgery....I have Keycare

I called the insurance company today to see if they would cover the surgery and if i needed another referral, and they said they don't cover the surgery...I need help, i'm so upset! Its BCBS Keycare PPO    — Cathy S. (posted on August 16, 2005)

August 16, 2005
Hun, I wish you the best of luck with getting approved. I had BCBS ppo of TX and I was was approved 2 week after my papers were submitted.
   — Stacie B.

August 17, 2005
Go to your benefits booklet and then the exclusions section. See exactly what it says. Do not take the answer you got on the phone as gospel until you see it in writing.
   — zoedogcbr

August 17, 2005
Ok first of all what state are u in some states with BCBS just flat out will not cover it FLA is one of them .....go to your benifits book and find bariatric or excluded procedures and see what it says if there is a section for bariatric look and see what u have to meet to be approved I have has patients call me with BCBS Cigna etc saying they called Ins. Company and they are excluding this surgery but what is amazing about it some decide to come to at least the first ofice visit and we submit the claim and it pays and then the pt. gets all labs and etc. required prior to surgery have all this done and call in ins. to get pre cert for the surgery and the pt. is approved one of my BCBS pt was denied ins. said she did not meet requirements well she 9 days post op so just a little pushing the ins company made them say heh seh does meet the requirements and everyone knows it and we are not going to get away with a denial.....Do not give up with just one phone call and one voice who know u may have talked to a new person that has no clue what they are reading....DO NOT GIVE UP
   — j s

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